Provider Demographics
NPI:1336386242
Name:LIFE CARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:LIFE CARE HOME HEALTH SERVICES LLC
Other - Org Name:THE CLINIC AT SANDHILL COVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:EYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-272-5866
Mailing Address - Street 1:800 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2581
Mailing Address - Country:US
Mailing Address - Phone:561-272-5866
Mailing Address - Fax:561-243-3733
Practice Address - Street 1:1600 SW CAPRI ST
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-4520
Practice Address - Country:US
Practice Address - Phone:772-419-2789
Practice Address - Fax:772-419-2786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBW798AMedicare Oscar/Certification